The Turkish Journal of Pediatrics
2014 , Vol 56 , Num 2
Risk Factors of Severe Atopic Dermatitis in Childhood: Single-Center Experience
Division of Pediatric Allergy and Immunology, Department of Pediatrics, Ankara Children’s Hematology Oncology Training
and Research Hospital, Ankara, Turkey. E-mail: cankocabas@yahoo.com
The aim of this study was to evaluate the risk factors of disease severity to
facilitate better management of children with severe atopic dermatitis (AD).
All the patients were diagnosed using Hanifin-Rajka criteria. After medical
and family histories were obtained and a detailed physical examination was
performed, disease severity was determined with the objective SCORing
Atopic Dermatitis (SCORAD) index. Skin prick tests were performed, and
percent of peripheral blood eosinophils, total serum IgE and specific IgE were
measured. The median age of the 501 patients was 15 months (interquartile
range [IQR]: 6-40 months), and 62.9% (315) were male. Sensitization to at
least one allergen and foods was observed in 40.3% (202) and 30.9% (155) of
all patients, respectively. Of the study group, 17.6% (88) had severe disease.
When logistic regression analyses were performed, with adjustments, the
risk factors for severe AD were determined to be eosinophilia (odds ratio
[OR] 1.137, 95% confidence interval [CI] 1.062-1.217; p=0.003) and food
allergen sensitization (OR: 1.937, 95%CI: 1.217-3.084; p=0.005). The patients
with severe AD had sensitization to common allergens, food allergens and
eosinophilia more frequently than those with mild-moderate disease (p=0.001,
p=0.001 and p=0.005, respectively). Eosinophilia may predict severe disease
and allergic sensitization. Further large-scale follow-up studies are needed to
improve the reliability and relevance of this relation.
Keywords :
severe atopic dermatitis, child, objective SCORAD, risk factors.